Faricimab may reduce intraretinal fluid accumulation in patients with diabetic macular edema (DME) more quickly and effectively than aflibercept, according to a study presented at this year’s Association for Research in Vision and Ophthalmology (ARVO) annual meeting held May 3-7, 2026, in Denver.
Faricimab differs from other DME agents due to its dual mechanism: it targets both VEGF-A and angiopoietin-pathways. To assess whether this dual mechanism translates into meaningfully greater fluid reduction, researchers used ROSA, a novel artificial intelligence (AI)-based algorithm designed to quantify retinal fluid volumes from optical coherence tomography (OCT) imaging.
The post hoc analysis drew from the pooled YOSEMITE/RHINE dataset, which included patients with center-involving DME randomized to faricimab 6 mg every 8 weeks (n=504), faricimab via a treat-and-extend regimen of every 4 to 16 weeks (n=506), or aflibercept 2 mg every 8 weeks (n=492). Both intraretinal fluid (IRF) and subretinal fluid (SRF) volumes were measured from baseline through week 100.
Reductions in subretinal fluid (SRF) were comparable across all 3 arms at year 2, with mean decreases of approximately 40 nL and 38.6 nL for faricimab groups and aflibercept respectively. Reductions in intraretinal fluid (IRF), which correlate more directly with vision impairment, told a different story. Both faricimab arms achieved mean IRF reductions of approximately 212 nL at year 2, compared with 184.1 nL with aflibercept – a statistically significant difference of roughly 28 nL (P <.0001).
The speed of fluid clearance also favored faricimab. Patients receiving aflibercept reached near-complete IRF resolution at a median of week 72, after a median of 11 injections. Both faricimab groups reached the same threshold at a median of week 36 – within half as much time and after only 6 to 7 injections (hazard ratio, 1.75; P <.0001 for both).
For patients with DME, persistent retinal fluid is a key driver of vision loss and a marker of inadequate disease control. Faricimab’s superiority — in both efficacy and speed of resolution — strengthens the case that its dual mechanism may offer a meaningful clinical advantage compared with VEGF monotherapy.
Results from this study “support the potential for dual angiopoietin-2/VEGF-A inhibition to improve DME disease control beyond VEGF inhibition alone,” the investigators report.
Furthermore, this study highlights how AI can impact both clinical research and physicians’ abilities to advance care for their patients. These data add a granular, novel dimension to what was already observed in the broader YOSEMITE/RHINE outcomes, providing further support for faricimab as a first-line option in DME management in the years ahead.
Disclosure: Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.